4TH Booster? 8x to 10x increase in antibodies but only 11% (Moderna) to 30% efficacy (Pfzer) - Israeli study

[connda]

Publish Israeli study of the 4th booster of Pfizer and Moderna vaccines.   The study's results and conclusions (we need a new generation of vaccines) says it all.  It's disturbing in a counter-intuitive way in that very high neutralizing (antibody) titers don't equate to high vaccine efficacy hence unusually high numbers of 'break-through cases.'  Even though a pre-print, it does provide a signal that there is a need for extensive research on newer, more effective vaccine technology.
 

"RESULTS Of 1050 eligible HCW, 154 and 120 were enrolled to receive BNT162b2 and mRNA1273, respectively, and compared to 426 age-matched controls. Recipients of both vaccine types had a ∼9-10-fold increase in IgG and neutralizing titers within 2 weeks of vaccination and an 8-fold increase in live Omicron VOC neutralization, restoring titers to those measured after the third vaccine dose. Breakthrough infections were common, mostly very mild, yet, with high viral loads. Vaccine efficacy against infection was 30% (95%CI:-9% to 55%) and 11% (95%CI:-43% to +43%) for BNT162b2 and mRNA1273, respectively. Local and systemic adverse reactions were reported in 80% and 40%, respectively.

CONCLUSIONS The fourth COVID-19 mRNA dose restores antibody titers to peak post-third dose titers. Low efficacy in preventing mild or asymptomatic Omicron infections and the infectious potential of breakthrough cases raise the urgency of next generation vaccine development." 

Source:
4th Dose COVID mRNA Vaccines’ Immunogenicity & Efficacy Against Omicron VOC
Gili Regev-Yochay, et.al., MedRxiv Feb 15, 2022
https://www.medrxiv.org/content/10.1101/2022.02.15.22270948v1

[ezzra]

I'm due for my paid 4th Moderna shot next month at the samitivej hospital....

[4MyEgo]

After 3 doses, the last being the booster, I think we all have to chill and allow herd immunity to take over, that and allow our B & T cells to do there thing when and if infected.

 

Continuing to get boosted every 3 months is going to be a waste of time and a strain on our immune system in my opinion.

 

More people vaccinated, more people unvaccinated being infected will eventually get us to where we need to be, then it will be an annual shot on top of all of the other shots we get.

 

Life back to normal soon, we hope, focus is now off Covid, need a war, oh, hang on a minute comrade. 

[ed strong]

"Publish Israeli study of the 4th booster of Pfizer and Moderna vaccines.   The study's results and conclusions (we need a new generation of vaccines) says it all.  It's disturbing in a counter-intuitive way in that very high neutralizing (antibody) titers don't equate to high vaccine efficacy hence unusually high numbers of 'break-through cases.'  Even though a pre-print, it does provide a signal that there is a need for extensive research on newer, more effective vaccine technology."

 

What on earth does that mean?

Going to have a new wave of vaccines?

[Paradise Pete]

1 hour ago, 4MyEgo said:

Continuing to get boosted every 3 months is going to be a waste of time and a strain on our immune system in my opinion.

It doesn't wear out from use, and being well prepared puts a lot less overall strain on our bodies when we do eventually get exposed to the virus.

[TallGuyJohninBKK]

This research has been reported on previously, and the findings included that the 4th vaccine continued to provide protection against serious COVId illness, even though very mild breakthru infections did occur... See below:

 

Fourth Pfizer Dose Is Insufficient to Ward Off Omicron, Israeli Trial Suggests

• Preliminary data found inoculation did increase antibodies
• Those with 4th shot only slightly less likely to get variant

 

 

" Still, those infected in the trial had only slight symptoms or none at all."

 

"Israel started rolling out the fourth dose of the vaccine to the over-60s and immunocompromised in late December amid a surge in cases.

 

Since then, more than half a million Israelis have received the extra dose, according to the Health Ministry. 

 

The decision to give the fourth vaccine to the most vulnerable was the correct one, Regev-Yochay said at a virtual press conference, because it may have given additional benefit against omicron. But the results didn’t support a wider rollout to the whole population, she added."

 

https://www.bloomberg.com/news/articles/2022-01-17/israel-trial-suggests-4th-dose-not-warding-off-omicron-infection

 

The full study report did actually comment on the 4th dose's likelihood to prevent serious COVID illness, saying of the breakthru infections that occurred:

 

"most of the infected HCW, in all groups complained of only negligible symptoms, which in many cases would not have been tested or reported, without the active surveillance.

...

The increased efficacy against symptomatic compared to asymptomatic infections found in this study suggest that the fourth dose may be more efficacious against severe disease and death, as was recently observed²². Therefore, older and vulnerable populations who are at higher risk for severe disease may benefit most from a fourth vaccine dose."

...

"Four to five months after the third dose, the fourth dose increases immunogenicity and restores it to levels comparable to peak antibody levels after the third vaccine dose. Thus, while mRNA vaccines seem to be highly potent and protective against severe disease, next-generation vaccines may be needed to provide better protection against infection with highly transmissible future variants."

 

https://www.medrxiv.org/content/10.1101/2022.02.15.22270948v1.full-text

 

Edited February 23, 2022 by TallGuyJohninBKK

[Paradise Pete]

13 minutes ago, ed strong said:

What on earth does that mean?

Going to have a new wave of vaccines?

It means they often don't prevent infection from the current variant, but they do greatly reduce the severity. The virus isn't going anywhere, and more mutations will come, so yes, better-tuned vaccines will be produced.

[orang37]

An interesting study with a large enough sample group to at least suggest indications for future research, but, note their were high percentages of adverse reactions, and low efficacy in terms of preventing reinfection.

 

Using a sample population of only health-care workers is, of course, is a hard limit on what the outcomes mean.

 

It would be more interesting if, among those reinfected, there was data of the severity of symptoms, and frequency of hospitalization, etc..

[TallGuyJohninBKK]

5 minutes ago, orang37 said:

note their were high percentages of adverse reactions,

If you read the full report, it indicates that pretty much all the adverse reactions that occurred were mild and resolved within a day or two post injection. The typical kind of post vaccination reactions.

 

"No serious adverse events were reported. No hospital admissions were reported."

 

 

 

Edited February 23, 2022 by TallGuyJohninBKK

[MrJ2U]

42 minutes ago, ed strong said:

Going to have a new wave of vaccines?

There already in trials for more effective vaccines.

 

 

[4MyEgo]

1 hour ago, Paradise Pete said:

It doesn't wear out from use, and being well prepared puts a lot less overall strain on our bodies when we do eventually get exposed to the virus.

I'm a big fan of Dr Paul Offit, interesting article if you care to read it.

 

https://www.dw.com/en/covid-do-multiple-boosters-exhaust-our-immune-response/a-60447735

[Bkk Brian]

1 hour ago, TallGuyJohninBKK said:

The decision to give the fourth vaccine to the most vulnerable was the correct one, Regev-Yochay said at a virtual press conference, because it may have given additional benefit against omicron. But the results didn’t support a wider rollout to the whole population, she added."

As in the UK, they will be offered in spring to the most vulnerable, over 75's and high risk. The correct decision for a Public Health dept as a  "precautionary" move.

[TallGuyJohninBKK]

1 hour ago, 4MyEgo said:

I'm a big fan of Dr Paul Offit, interesting article if you care to read it.

 

https://www.dw.com/en/covid-do-multiple-boosters-exhaust-our-immune-response/a-60447735

 

"Offit's concern isn't focused on the possibility of potential T-cell exhaustion, but rather the unsustainability of a health strategy centered around trying to prevent mild illness....  some vaccinated people will develop mild cases of COVID-19.

 

"That's okay,” said Offit, adding that the vaccines are working like they're supposed to. "You just want it to keep you out of the hospital, out of the intensive care unit and out of the morgue, and it was doing that. But we labeled those cases breakthroughs, which was, I think, a communications error, and then held this vaccine to a standard that we hold no other mucosal vaccine to."

...

"US health officials authorized booster doses in order to prevent mild illness, Offit said. But the focus should instead be on administering first and second vaccine doses to people who are unvaccinated, rather than continuing to boost people who have already gotten their first two shots, he told DW."

 

Ya, like that's going to happen among the whack job remaining anti-vax segment of the U.S.... which happens to be about one-third of the country. And we all know who they are....

 

Vaccines should go to the people who can benefit from them, and who want them, including the elderly and other at-risk segments whose immune systems need that extra boost.

 

Edited February 23, 2022 by TallGuyJohninBKK

[Paradise Pete]

1 hour ago, 4MyEgo said:

I'm a big fan of Dr Paul Offit, interesting article if you care to read it.

 

https://www.dw.com/en/covid-do-multiple-boosters-exhaust-our-immune-response/a-60447735

Interesting article. It only raises the question, though, it doesn't answer it. Offit isn't recommending boosters among otherwise healthy people because he doesn't see the value in it - he's just saying go ahead and get a mild illness.

 

As you're a fan you may well have seen this, but here is a good discussion with him:

 

 

[Pravda]

6 hours ago, ezzra said:

I'm due for my paid 4th Moderna

 shot next month at the samitivej hospital....

 

How did you feel after 3rd shot? I was crying like baby after the 2nd, so I'm really looking to just give away my 2 leftover paid moderna shots. 

 

Or maybe not. 

[unblocktheplanet]

This Israeli study is a real ball-breaker. You can get better efficacy against infection with a fourth-dose booster from Pfizer but double the number of adverse reactions. I wonder if efficacy & adversity are correlated.

 

Appears we'll be masking & vaxxing forever.

[GroveHillWanderer]

4 hours ago, 4MyEgo said:

I'm a big fan of Dr Paul Offit, interesting article if you care to read it.

It is an interesting article and what it mentions several times over, is that there is no clinical evidence that repeated vaccinations can lead to T cell exhaustion. The phenomenon has only been seen in HIV or cancer patients where constantly repeated immunological treatments are given much, much more frequently than every few months.

 

As for Dr Offit, he is characterized as having no concern over the possibility of immune system exhaustion related to Covid vaccinations.

[Jingthing]

I think where we're going is the development of a new for lifetime vaccine OR annual vaccinations after booster. Like the annual flu vaccine.

[connda]

8 hours ago, 4MyEgo said:

After 3 doses, the last being the booster, I think we all have to chill and allow herd immunity to take over, that and allow our B & T cells to do there thing when and if infected.

 

Continuing to get boosted every 3 months is going to be a waste of time and a strain on our immune system in my opinion.

 

More people vaccinated, more people unvaccinated being infected will eventually get us to where we need to be, then it will be an annual shot on top of all of the other shots we get.

 

Life back to normal soon, we hope, focus is now off Covid, need a war, oh, hang on a minute comrade. 

The human immune system isn't built to be jacked up on antibodies to a specific pathogen 365 days a year ... forever.  That's the purpose of memory B and T cells - to call up antibodies as needed.  So what is the result of the pharmaceutical industry's vaccine experiment that keeps the human body full of antibodies to one specific pathogen for extended periods of time?  Months? Years? 
Perhaps we are now finding out.  The pathogens become antibody resistant or some equally disturbing mechanism that renders additional vaccinations ineffective?  I'm just speculating.  Time will tell.  Which was always the purpose of long-term studies.

[connda]

1 hour ago, Jingthing said:

I think where we're going is the development of a new for lifetime vaccine OR annual vaccinations after booster. Like the annual flu vaccine.

Yeah.  This is in the realm of new vaccine technology. 

[Virt]

Here in Denmark they dropped the 4th shot for now, and even dropped the 3rd shot for young people.

 

They still haven't decided what will happen when Moderna and Pfizer release their updated vaccines.

I don't think we will be offered anymore vaccines until very late this year.

 

We can't buy a 4th shot if we want it since it's controlled by the government,

 and they haven't given the permission to buy shots.

 

I probably get my 4th shot if they offer it later this year.

Depends on the situation later this year.

[Bkk Brian]

Personally I see a lot of scare mongering posts, not necessarily on this thread but certainly dotted around others by vaccine skeptics or outright anti vaxxers making unsubstantiated claims that boosters will need needed every month, the dangers of anti body resistance, long term side effects etc etc................

 

This OP is based on one study from Israel that actually cited the benefits for the older/vulnerable to get a 4th shot but not for the wider population. Surely this is good news, that further boosters for the young/healthy are not needed presently warranted. A yearly booster offered to the elderly or at high risk is simply the same as an annual flu shot. Its a precaution that people can take if they feel they need to, its not forced on them.

 

In the absence of a perfect vaccine to cover all variants and there will of course be more to come then we have to work with what is available. 

 

Latest results from the UK ONS Infection Survey, antibody data, 23 February which is a far larger ongoing survey than the Israel study paint a very different picture.

 

This is very encouraging - and somewhat unexpected given the waning seen in eg. Israel (which may reflect the different combinations of vaccine/dosing intervals or higher hybrid immunity) and should mean current positive trends in hospital admissions and deaths should continue.

 

Latest antibody data from ONS shows sustained high levels at older ages, even after 4 months since boosting of the oldest groups started. Note that only the much higher threshold, recently added to the survey, is now used, up from 42 to 179ng/ml.

Report:

Coronavirus (COVID-19) Infection Survey, antibody data, UK: 23 February 2022

 

[ed strong]

23 hours ago, MrJ2U said:

There already in trials for more effective vaccines.

 

 

Let's hope these ones are better then.

 

If not 3rd time lucky on the following vaccines!

 

 

[ed strong]

23 hours ago, Paradise Pete said:

It means they often don't prevent infection from the current variant, but they do greatly reduce the severity. The virus isn't going anywhere, and more mutations will come, so yes, better-tuned vaccines will be produced.

Infections are at very low levels compared to last year?

[Paradise Pete]

18 hours ago, ed strong said:

Infections are at very low levels compared to last year?

Where is that question coming from? I didn't say that, and with omicron it's obviously not true. Maybe I'm misunderstand your question?

[GroveHillWanderer]

On 2/23/2022 at 8:59 PM, Jingthing said:

I think where we're going is the development of a new for lifetime vaccine OR annual vaccinations after booster. Like the annual flu vaccine.

I can see where the development of vaccines that confer mucosal immunity might provide better and longer-lasting immunity but I'm not sure about it being life-long.

 

Coronaviruses do mutate and although they don't do so nearly as quickly or as radically as the flu, we've already seen, even within a year or so, variants have arisen with a fairly large level of immune escape, so I don't see a vaccine that will protect a person for life.

 

This is in stark contrast to viruses like measles that can't and don't change in a way that would avoid vaccine-induced immunity, as explained in the link below.

 

Why measles doesn't evolve to escape immunity 

 

However I also don't think we'll need yearly boosters - as alluded to above, coronaviruses don't mutate like the flu. From various articles I've read recently (mainly those about long-lasting cellular immunity) I would tend to agree with those scientists who think that people who are fully immunized and who've had a booster shot, probably won't need another vaccination for 4-5 years at least, possibly even longer.

 

Maybe that's just wishful thinking, but I hope not.

 

As the NY Times article below says:

 

Quote

A flurry of new studies suggests that several parts of the immune system can mount a sustained, potent response to any coronavirus variant.

Got a Covid booster? You probably won't need another for a long time.

Edited February 25, 2022 by GroveHillWanderer